{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:31:50Z","timestamp":1787167910170,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,6,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Exercise stress testing for cardiovascular assessment in kidney transplant candidates has been shown to be a feasible alternative to pharmacologic methods. Exercise stress testing allows the additional assessment of exercise capacity, which may have prognostic value for long\u2010term cardiovascular outcomes in pre\u2010transplant recipients. This study aimed to evaluate the prognostic value of exercise capacity on long\u2010term cardiovascular outcomes in kidney transplant candidates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We retrospectively evaluated exercise capacity in 898 consecutive kidney transplant candidates between 2013 and 2020 who underwent symptom\u2010limited exercise stress echocardiography for pre\u2010transplant cardiovascular assessment. Exercise capacity was measured by age\u2010 and sex\u2010predicted metabolic equivalents (METs). The primary outcome was incident major adverse cardiovascular events, defined as cardiac death, non\u2010fatal myocardial infarction, and stroke. Cox proportional hazard multivariable modeling was performed to define major adverse cardiovascular events predictors with transplantation treated as a time\u2010varying covariate. A total of 429 patients (48%) achieved predicted METs. During follow\u2010up, 93 (10%) developed major adverse cardiovascular events and 525 (58%) underwent transplantation. Achievement of predicted METs was independently associated with reduced major adverse cardiovascular events (hazard ratio [HR] 0.49; [95% CI 0.29\u20130.82],\n                      <jats:italic>P<\/jats:italic>\n                      =0.007), as was transplantation (HR, 0.52; [95% CI 0.30\u20130.91],\n                      <jats:italic>P<\/jats:italic>\n                      =0.02). Patients achieving predicted METs on pre\u2010transplant exercise stress echocardiography had favorable outcomes that were independent (HR, 0.78; [95% CI 0.32\u20131.92],\n                      <jats:italic>P<\/jats:italic>\n                      =0.59) and of similar magnitude to subsequent transplantation (HR, 0.97; [95% CI 0.42\u20132.25],\n                      <jats:italic>P<\/jats:italic>\n                      =0.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Achievement of predicted METs on pre\u2010transplant exercise stress echocardiography confers excellent prognosis independent of and of similar magnitude to subsequent kidney transplantation. Future studies should assess the benefit on exercise training in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.025862","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T06:38:02Z","timestamp":1655188682000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic Value of Exercise Capacity in Kidney Transplant Candidates"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2772-0695","authenticated-orcid":false,"given":"Sean","family":"Tan","sequence":"first","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Wen","family":"Thang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Mulley","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Health Melbourne Victoria Australia"},{"name":"Department of Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevan R.","family":"Polkinghorne","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Health Melbourne Victoria Australia"},{"name":"Department of Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Ramkumar","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria 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Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Nolan","sequence":"additional","affiliation":[{"name":"Baker Heart and Diabetes Institute Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Moir","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0589-0367","authenticated-orcid":false,"given":"James D.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip M.","family":"Mottram","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3437-8648","authenticated-orcid":false,"given":"Nitesh","family":"Nerlekar","sequence":"additional","affiliation":[{"name":"Monash Cardiovascular Research Centre, Victorian Heart Institute Monash University Melbourne Victoria Australia"},{"name":"Monash Heart Monash Health Melbourne Victoria Australia"},{"name":"Baker Heart and Diabetes Institute Melbourne Victoria 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